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Netilmicin 150 mg every 12 hours in systemic infections
Abstract:
Most (76%) of the 284 gentamicin-resistant Enterobacteriaceae isolated from patients hospitalised in Eindhoven or its vicinity proved to be sensitive to netilmicin. The sensitivity rate was 96% for amikacin and 97% for cefotaxime. Thirty-four patients with systemic infections and isolation of netilmicin-sensitive Enterobacteriaceae were treated with 150 mg netilmicin intravenously every 12 h. All except one patient reacted favourably. The patient who did not had a netilmicin-sensitive Escherichia coli septicaemia which recurred during treatment. The treatment was well tolerated. No ototoxicity or permanent nephrotoxicity were noted. Although the variation of serum levels was as great for netilmicin as has been reported for other aminoglycosides, they were in general within acceptable limits. In patients with reduced renal function peak levels above 16 mg/l were found five times more frequently than in patients with normal renal function. However, serum levels should also be monitored in patients with normal renal function.
Insights
Most gentamicin-resistant Enterobacteriaceae infections responded well to netilmicin, showing high sensitivity rates. Clinical trials indicate netilmicin is a safe and effective treatment option for these infections.
Area of Science:
- Clinical Microbiology
- Infectious Diseases
- Pharmacology
Background:
- Gentamicin resistance in Enterobacteriaceae poses a significant clinical challenge.
- Emerging antibiotic resistance necessitates the evaluation of alternative treatment options.
Purpose of the Study:
- To assess the in vitro susceptibility of gentamicin-resistant Enterobacteriaceae to netilmicin.
- To evaluate the clinical efficacy and safety of netilmicin in treating systemic infections caused by susceptible Enterobacteriaceae.
Main Methods:
- In vitro susceptibility testing of 284 gentamicin-resistant Enterobacteriaceae isolates.
- Prospective clinical trial involving 34 patients with systemic infections treated with intravenous netilmicin.
Main Results:
- High in vitro sensitivity rates to netilmicin (76%), amikacin (96%), and cefotaxime (97%).
- Favorable clinical response in 33 out of 34 patients treated with netilmicin.
- Netilmicin treatment was well-tolerated, with no observed ototoxicity or permanent nephrotoxicity.
Conclusions:
- Netilmicin demonstrates significant in vitro activity against gentamicin-resistant Enterobacteriaceae.
- Intravenous netilmicin is an effective and safe therapeutic option for systemic infections caused by susceptible strains.
- Monitoring of netilmicin serum levels is recommended, particularly in patients with impaired renal function.